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Anatomical characteristics and classifications of Henle’s trunk in laparoscopic right hemicolectomy – a multicenter clinical trial.

Jing Sun, Zirui He, Hao Su, Sen Zhang, Bo Feng. Shanghai Jiao Tong University School of Medicine affiliated Ruijn Hospital

BACKGROUND: Henle’s trunk (HT) is a convergence of veins lies in transverse retro-colic space(TRCS). The recognition and accurate dissection of HT is the key to reduce intraoperative blood loss and postoperative complication in laparoscopic right hemi-colectomy. Though the complexity and importance of HT was acknowledged, studies on direct intraoperative observation of HT were still lacking.

METHODS: One hundred and fifty-five patients from 16 hospitals in China who underwent laparoscopic right hemi-colectomy were included. The HT was intraoperatively observed and measured by qualified surgical teams.  All the HT were categorized into 4 types, and the average length of HT was calculated. All the pictures of HT and clinical data of patients were collected for further analysis.

RESULTS: The Helen’s trunk was observed intraoperatively in all 175 patients. The anatomical variations of HT were classified into four types based on the numbers of colic tributaries of the HT. Type-0 was defined as a type with no colic tributary(Figure 1). In type-I, only one colic drainage vein joined to HT(Figure 2). Type-II possess two colic veins(Figure 3), and there are three colic veins join the trunk in Type III(Figure 4). The frequencies of Type-0, Type-I, Type-II and Type-III were 16%(n=28), 54%(n=94), 28%(n=49) and 2%(n=4), respectively(Figure 5). Among all the tributary situations, RCV+RGEV+ASPDV was most frequently seen(47%, n=82), followed by RCV+sRCV+RGEV+ASPDV(17%, n=29)(Figure 6). The average length of Henle’s truck was 8mm, which was shorter than those reported from western countries.


 


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95786

Program Number: S035

Presentation Session: Colorectal I

Presentation Type: Podium

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